Tina Marie Pristach-Patrick, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP4179 Issued in AZ

Practice address

5224 W Dove Centre Rd
Marana, AZ 85658-5063

Phone

(520) 616-1445

Fax

(520) 616-1446

NPI assigned

Sep 2, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Tina Marie Patrick Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

50.84 of 100Reported as group

Quality

7.69

Promoting interoperability

100

Improvement activities

0

Cost

78.46

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northwest Urgent Care LLC

  • Urgent Care Clinic/Center
  • Tucson, AZ
  • NPI 1528683455

  AZ

  Medicare reassignment NPD
• Emil H Annabi MD PC

  • Anesthesiology Physician
  • Tucson, AZ
  • NPI 1245635390

  AZ

  Medicare reassignment
• Emil H Annabi MD PC

  • Anesthesiology Physician
  • Tucson, AZ
  • NPI 1750146130
  NPD
• Emil H Annabi MD PC

  • Anesthesiology Physician
  • Tucson, AZ
  • NPI 1902661390
  NPD (past)
• Marana Health Center, Inc

  • Clinic Pharmacy
  • Tucson, AZ
  • NPI 1073072450
  NPD (past)
• Strato3 Health LLC

  • Specialist
  • Tucson, AZ
  • NPI 1215426200

  Family Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1982985057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-682-4111",
            "fax_number": "520-682-3817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5224 W DOVE CENTRE RD",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856585063",
            "telephone_number": "520-616-1445",
            "fax_number": "520-616-1446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7725 N Oracle Rd",
            "address_2": "Suite 131",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857046986",
            "country_code": "US",
            "telephone_number": "520-544-2273",
            "fax_number": "520-544-4227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRISTACH-PATRICK",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-02",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP4179",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "AP4179",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "667808",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "PATRICK",
            "middle_name": "MARIE",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Delores Ann Ponce de Leon, MA
• Frank J Pones Jr.
• Positive Pursuits, LLC
• Heather Poulin, RN
• Premise Health of Arizona Medical PC
• John Prohaska, LCSW
• Raquel Ramirez, LISAC
• Melanie Lynne Randall, MS, CCC-SLP
• Heather Raney, M.S., CCC-SLP
• Elizabeth Reaves

• All providers in Marana, AZ
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.